title: Nateglinide and acarbose for postprandial glucose control after optimizing fasting glucose with insulin glargine in patients with type 2 diabetes.
abstract: OBJECTIVE
  Basal insulin treatment is frequently used in type 2 diabetes, but the successful control of postprandial glucose is challenging. We compared the effect of preferential postprandial glucose targeting drugs for postprandial glucose control after optimizing fasting glucose with basal insulin.
  
  
  METHODS
  This study was performed in 58, insulin naïve type 2 diabetes. After fasting glucose was optimized by insulin glargine, nateglinide or acarbose was initiated and then crossed over after second wash out period. 75 g oral glucose tolerance test and 7 point self monitoring blood glucose for 3 days at the end of each period was performed.
  
  
  RESULTS
  Both drugs effectively reduced postprandial glucose levels compared with the insulin glargine monotherapy. No significant differences were found between nateglinide and acarbose in terms of mean glucose level, standard deviation of glucose levels, mean average glucose excursion and average daily risk range. Homeostasis model analysis (HOMA)% β, corrected insulin response and insulin-to-glucose ratio were significantly higher in the responder group compared with the non-responder. There was no episode of severe hypoglycemia.
  
  
  CONCLUSIONS
  Nateglinide and acarbose are equally effective in type 2 diabetes for postprandial glucose excursions during basal insulin treatment. The markers of beta cell function might be used for predicting response. (Clinical trial reg. no. NCT 00437918, clinicaltrial.gov.).
authors.affiliation: Department of Internal Medicine, Maryknoll Medical Center, Busan, Republic of Korea; Molecular Therapy Lab, Paik Memorial Institute for Clinical Research, Inje University, Busan, Republic of Korea.
authors.forename: Mi K
authors.initials: MK
authors.lastname: Kim
authors.forename: Ji H
authors.initials: JH
authors.lastname: Suk
authors.forename: Min J
authors.initials: MJ
authors.lastname: Kwon
authors.forename: Hye S
authors.initials: HS
authors.lastname: Chung
authors.forename: Chang S
authors.initials: CS
authors.lastname: Yoon
authors.forename: Hye J
authors.initials: HJ
authors.lastname: Jun
authors.forename: Jung H
authors.initials: JH
authors.lastname: Ko
authors.forename: Tae K
authors.initials: TK
authors.lastname: Kim
authors.forename: Soon H
authors.initials: SH
authors.lastname: Lee
authors.forename: Min K
authors.initials: MK
authors.lastname: Oh
authors.forename: Byoung D
authors.initials: BD
authors.lastname: Rhee
authors.forename: Jeong H
authors.initials: JH
authors.lastname: Park
mesh_terms: D020909:Acarbose / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000187:drug effects*; D003510:Cyclohexanes / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D008297:Male; D008875:Middle Aged; D000077715:Nateglinide; D010649:Phenylalanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019518:Postprandial Period; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D003510:Cyclohexanes; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D000077715:Nateglinide; D010649:Phenylalanine; D020909:Acarbose